Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,386.40 / $3,386.40 / $28,445.80	Facility		$3,386.40	$3,386.40	$28,445.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,264.00 / $3,386.40 / $3,725.04	Professional		$3,264.00	$3,386.40	$3,725.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,655.89 / $3,121.20 / $4,896.00	Facility		$1,655.89	$3,121.20	$4,896.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,209.59 / $3,468.00 / $6,519.84	Professional		$1,209.59	$3,468.00	$6,519.84
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $98.60 / $3,720.00	Facility		$76.20	$98.60	$3,720.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $3,386.40 / $3,386.40 / $7,290.58	Professional		$3,386.40	$3,386.40	$7,290.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $3,468.00	Facility		$3,468.00	$3,468.00	$3,468.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $3,468.00	Professional		$3,468.00	$3,468.00	$3,468.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $2,800.00 / $2,800.00 / $3,360.00	Professional		$2,800.00	$2,800.00	$3,360.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $638.07 / $3,876.00	Professional		$393.93	$638.07	$3,876.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,241.42 / $14,840.00 / $15,300.00	Facility		$6,241.42	$14,840.00	$15,300.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $15,504.00 / $15,504.00 / $18,360.00	Professional		$15,504.00	$15,504.00	$18,360.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $85.00	Professional		$60.00	$60.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,304.80 / $4,080.00 / $5,038.80	Facility		$3,304.80	$4,080.00	$5,038.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $3,468.00 / $3,468.00 / $4,689.96	Professional		$3,468.00	$3,468.00	$4,689.96
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $2,800.00 / $4,200.00 / $4,760.00	Professional		$2,800.00	$4,200.00	$4,760.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,400.00 / $3,400.00 / $6,531.40	Professional		$3,400.00	$3,400.00	$6,531.40